Do a better job with mental health

Emma Bailey

Now the shape of our new political landscape is clear, it’s timely to remember that on one issue politicians of all parties express agreement, that we must improve the appallingly low rate of success so far achieved by Government programmes which are intended to help people with mental health problems back into employment.

About one million people in the UK are out of work as a result of a mental health problem, while less than 10 per cent of people who use mental health services are in paid work – yet many more would like the chance to work, and can, given the right support. This is not only a challenge for individuals, but also for the economy – poor mental health was estimated by the OECD to cost the UK economy 4.5% of GDP annually.

In the last Parliament, MPs of all parties championed new ways of supporting people with mental health conditions into work by arguing for better social care, education and employment opportunities.

In 2014 a series of evidence-based pilot projects were run, focussed on improving the performance of the Job Centre and the Work Programme in helping people with mental health conditions back to work. Both Centre for Mental Health and The Work Foundation (along with many other experts) have informed and supported various projects and pilots which seek to do just that. Through our work we have met many people with both common and severe mental health conditions, for whom these schemes worked. Some thought their mental health such a barrier that they would never be able to work again, but are now working in a job paying a living wage. We have identified programmes that work - not only supporting employment, but also supporting health and wellbeing.

It is going to be ever more important that the new Government follows through on its manifesto promises to press on with new ways of removing barriers that stop disabled people from participating in the workforce. They have pledged to deliver this through mechanisms such as social impact bonds and payment-by-results, and pledged in particular to provide ‘significant new support’ into employment for working age people with mental health conditions.

We call on the new government to implement what works. There is substantial evidence to go on. Research has consistently shown that a personalised approach to helping people return to work which is integrated with mental health care, based on voluntary participation and no exclusion, and which actively engages with and supports employers, is the most effective model of support. This approach, known as Individual Placement and Support (IPS), is increasingly being adopted in the NHS and has already helped many more people with mental health conditions to re-join the labour market, contributing their skills and knowledge to our national productivity.

An important source of support for many, we know that Access to Work has unfulfilled potential to help many more people with mental health problems at work. Reports that the scheme will be cut back and funding capped will cause great concern for many and could undermine efforts to help more people into paid work.

One the greatest barriers to keeping your job when you are one of the 1 in 6 people of working age with a mental health condition, is other people’s attitudes towards your health. It makes sense to ensure that people in work who develop mental health problems receive the support they need to retain their employment, without concern about being stigmatized or disadvantaged when they ask for help.

We know that people in many workplaces do not feel confident that they would get help from their employer, and fear the consequences of disclosing mental health problems. This Government should thus continue to support the highly successful and well known Time to Change anti-stigma initiative.

Dame Carol Black identified the workplace as a key setting for supporting the health and wellbeing of the working age population. Often poor mental health goes unrecognised in the workforce, and many employers are not aware of the considerable role poor employee mental health has on their business. Mental health is a workplace issue, and if it is not recognised and addressed by employers, it leads to job loss and labour market loss. Government’s attention needs to be on how they can encourage, incentivise and support employers to be aware of the impact of mental health problems on their business, and invest in the health and wellbeing of their employees.

The facts remain, though, that even when people ask for help from the NHS, there are often long waiting lists for effective and appropriate treatment. The Conservative Party manifesto pledged speedier access to the necessary care and treatment to reduce the opportunities lost through enduring mental ill-health. This must happen. Until we achieve, through education, legislation and leadership, a genuine parity of esteem between mental and physical conditions the scandal of untreated mental ill health and consequent lost productivity will endure in our workplaces. Addressing the mental health needs of the whole population is not only a health system priority, but also a labour market priority, and concerted action must be taken.

The same is true of securing appropriate timely, treatment and support for children and young people. In order to build a stronger workforce for the future we must ensure that early intervention with effective treatment is available for our young people who experience first episodes of mental health problems, or childhood behavioural problems, which are a major risk factor for mental health conditions in adolescence and adult life.

We call upon the new Government to follow through on its promises to invest in the NHS and create a pathway back to work where health and employment services work together seamlessly and swiftly. A new generation is hoping for better and we simply cannot afford to go on wasting the economic potential of a large proportion of the working age population, just because we are not investing in what we know works.

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